Week 4: Trends & Issues in Executive Management for Health care Administrators

Trends in Health Care Reimbursement (Volume to Value)

As the health care delivery landscape continues to evolve, how might health care executives address the move from volume to value?

As you have examined thus far in this course, the patient experience and consumer-driven health care greatly impact the success of health care organizations. Health care executives must continually strive to effectively and efficiently deliver high-quality and low cost health care services rather than focusing solely on receiving accolades in terms of patient utilization and satisfaction. This move toward consumer-driven health care then impacts the degree to which health care reimbursements and payments for services are handled in a health care organization. Departures from fee-for-service in favor of fee-for-value provide health executives many opportunities to enhance health care delivery for their patients and consumers.

This week, you explore trends in health care reimbursement that focus on moving from volume to value. You consider how these trends impact health care organizations and decision making for the health care executive.

Learning Objectives

Students will:

· Evaluate value-based methodologies for health care organizations

· Analyze executive briefs for value-based care models

Learning Resources

This page contains the Learning Resources for this week. Be sure to scroll down the page to see all of this week’s assigned Learning Resources. To access select media resources, please use the media player below.

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

Required Readings

Gehardt, W., Korenda, L., Morris M., & Vadnerkar, G. (2015). The road to value-based care: Your mileage may vary. Westlake, TX: Deloitte University Press.

Hundange, V., Riner, N., Aagard, M., & Riner, R. (2016). Adopting new cardiovascular models to achieve value-based care. Physician Leadership Journal, 3(2), 34-42.

Miller, H. D. (2009). From volume to value: Better ways to pay for health care. Health Affairs, 28(5), 1418-28.

VanLare, J. M., & Conway, P. H. (2012). Value-based purchasing — national programs to move from volume to value. The New England Journal of Medicine,367(4), 292-5.

Discussion Part

Volume to Value(2pages)

Moving from volume- to value-based payment methodologies can be challenging due to the cost of implementing them and to the variety of payment structures. The type of value-based program that works for one health care organization may not be the right fit for another. How do you as a health care executive determine the right structure for your organization? What do you need to take into consideration as you look at shifting from traditional payment methodologies to value-based care?

1. For this Discussion, review the resources for this week and reflect on the challenges health care executives might face when transitioning the payment methodology in a health care organization to a value-based model. Consider how the move to a value-based model might impact health care delivery for the health care organization.

By Day 3

2. Post an explanation of how you, as a current or future health care executive, would choose a value-based methodology for the health care organization that you currently work in or one with which you are familiar. Describe the organization’s current payment methodology, and explain your rationale for choosing to move to your chosen model. Be specific and provide examples.

By Day 5

3. WWWContinue the Discussion and respond to two of your colleagues by providing feedback and recommendations regarding their choices of value-based models and rationales for their choices.

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 4 Discussion Rubric

Post by Day 3 and Respond by Day 5

To participate in this Discussion: Week 4 Discussion

Assignment Part (APA format 7th ed, 2 pages)

Volume to Value: Executive Brief

1. How might health care executives choose a value-based care model for their organization? What would you, as a current or future health care executive, need to consider in making this choice? Are there other leaders within your organization who you would want to involve in making this decision?

2. Questions such as these are critical for your role as a current or future health care executive. Ensuring that your organization makes the best choice of a value-based care model, while informing the board of directors and other departments, is a critical responsibility of your role. Practice in developing executive briefs that may be presented to the board of directors for a health care organization is meaningful in helping guide necessary and sufficient information to enact initiatives for health care delivery.

3. For this Assignment, review the resources for this week. Consider how you, as a current or future health care executive would choose a value-based care model for your health care organization. Reflect on those key points that you would highlight as most critical in an executive brief for your board of directors.

The Assignment: (2 pages)

· Write an executive brief that you would present to the board of directors that highlights your choice of value-based care model. Provide your rationale for choosing this model over others for your organization.

· Be sure to incorporate feedback and recommendations suggested by your colleagues in this week’s Discussion.

By Day 7

Submit your Assignment.

Submission and Grading Information

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Grading Criteria

To access your rubric:

Week 4 Assignment Rubric

Check Your Assignment Draft for Authenticity

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Submit your Week 4 Assignment draft and review the originality report.

Submit Your Assignment by Day 7

To submit your Assignment: Week Assignment